Father of IVF wins Nobel Prize in Medicine

The Nobel Prize committee announced today that 85 year old British scientist Robert G. Edwards, PhD was awarded the Nobel Prize in Physiology for pioneering human in vitro fertilization lab techniques that culminated in the birth of Louise Brown, the world’s first IVF baby. Robert Edwards partnered with gynecologist, Patrick Steptoe, MD to bring his bench top expertise to the patient. Except for the fact that Dr. Steptoe died in 1988 and the Nobel prizes are only awarded to living persons, he would certainly have shared the honor with Dr. Edwards. You can watch a video of Dr. Steptoe actually delivering Louise Brown in 1978.

At the end of the video, Dr. Edwards is asked to step into the OR and hold the baby and Dr. Steptoe acknowledges his considerable contribution to IVF. Discoveries rarely occur de novo. All science is built on the work of previous scientists and the development of IVF is no exception. Dr. Edwards pioneering work was built on decades of work by other scientists. You can read a time line of the history of IVF here. It is a fascinating history, peopled by scientists from all over the world working with all kinds of animals from rabbits to mice to domestic animals.

You will actually hear Louise Brown’s first lusty cry on the video, and maybe like me, you’ll choke up when you hear that cry, realizing that this baby’s birth made IVF a real clinical treatment for millions of future infertile couples who would otherwise never have any chance to have children born to them. What is so remarkable about this video is that they made it hoping that the baby would be normal, but they didn’t know for sure. All tests pointed toward that outcome, yet until she was pulled from her mother’s womb into the light, IVF was still a vast unknown. Louise Brown turned out to be a healthy baby and grew up to be a healthy woman who conceived children without the use of any assisted reproductive techniques. Louise Brown’s younger sister Natalie was the first IVF baby to have a baby herself (without IVF).

Interestingly, the first IVF baby might well have been born four years earlier in the US. A New York gynecologist Landrum Shettles was in the middle of a clinical attempt to combine egg and sperm in vitro for a infertile Florida couple, but the chairman of Shettles’s department ordered that the experiment be stopped. The Florida couple sued the Chairman for stopping the experiment and robbing them at a chance for conceiving a child. Ironically, after losing the lawsuit and being ordered to pay the Florida couple $50,000, the Chairman,Raymond Vande Wiele eventually became a fan of IVF and became the co-director of the first IVF clinic in New York City at Columbia in 1983.

There was a lot of resistance about IVF in the beginning from people who thought IVF was a threat to civilization itself. This fascinating 2003 article in Scientific American talks about the fears some people had concerning IVF and compared it to more recent concerns raised about human cloning. (Post note: link to article revised; free article no longer available on-line). Dr. Steptoe’s warning at the end of the video is interesting because it cautioned that IVF was at it’s infancy but he hoped that someday it would be widely available all over the world. He got his wish. Since 1978 when baby Brown was born until today, IVF has exploded and more than a million babies have been born.. Births from IVF account for more than 1% of all births in developed countries worldwide.

Some concerns about the health of IVF babies persist. IVF helps couples conceive who may in part be infertile due to underlying health conditions or genetic issues. This makes it very difficult to determine whether increased health problems noted among a small percent of IVF babies is due to the IVF procedure itself or due to inherent medical issues of the patient population that needs IVF. Health issues noted among some IVF children is smaller birth weight (even in singleton babies) and some genetic diseases that are now passed on through the success of IVF. The reported increased risk of ovarian cancer from stimulation medications has not been validated by newer studies. Unfortunately, because the anti-abortion political forces have worked diligently to kill any sort of NIH funding in the US for IVF, we have no national reporting system to look at long term effects and all IVF advances are paid for by patients who are desperate for solutions today. Ironically, the effort to stop IVF has simply left it largely unregulated in the US, compared to other countries.

Dr. Edwards earned the Nobel Prize in part for his persistence in spite of considerable public concern and disapproval according to Christer Höög, a member of the Nobel Prize committee, who wrote this comment on the Nobel Foundation’s Web page (as reported by the NY Times), “In retrospect, it is amazing that Edwards not only was able to respond to the continued criticism of in vitro fertilization, but that he also remained so persistent and unperturbed in fulfilling his scientific vision.”